David Schult, Medicare Insurance Agent

Answer: Medicare is becoming more expensive over time because more people are using it, living longer, and healthcare itself costs more each year. While parts of the program may face funding shortfalls in the future, that doesn’t mean it will disappear—just that lawmakers will likely need to adjust taxes, benefits, or rules to keep it running, as they’ve done in the past.

Answer: If you are homebound and have a heart condition, Medicare may help cover remote monitoring and care. Medicare Part B can pay for remote patient monitoring, which lets your doctor track things like your heart rate or blood pressure from devices you use at home, as long as your doctor says it is medically necessary. If a doctor certifies that you are homebound, Medicare may also cover home health services, such as skilled nursing visits to help manage your heart condition, often at little or no cost to you. Medicare can also cover some telehealth doctor visits from home, and Medicare Advantage plans may offer extra benefits like more telehealth or monitoring programs, depending on the plan.

Answer: The right plan is the one that covers your specific meds, at the lowest total yearly cost, even if the premium is a few dollars higher.

Answer: Medicare fully covers only these vaccines at no cost: under Part B, the flu shot, COVID-19 vaccines and boosters, pneumonia vaccines, and Hepatitis B if you’re high-risk; under Part D, routine adult vaccines such as shingles (Shingrix), Tdap/tetanus, and RSV are also covered at $0, typically when given at a pharmacy with a Part D plan in place.

Answer: Medicare Part B nutrition counseling (medical nutrition therapy) is a preventive care service if you have diabetes. It’s a valuable covered benefit you can use to help manage blood glucose and support overall diabetes care with little to no cost, so long as you get a doctor’s referral and see a qualified provider.

Answer: Most people should sign up for Medicare when they turn 65, unless they have good employer insurance. Here’s the plain version:

Yes, sign them up if your parents are 65 or older and do not have Medicare yet. This avoids penalties and gaps in coverage.

They may wait if they are still working and have active employer coverage from a company with 20 or more employees. In that case, delaying Part B is usually allowed without penalty.

If they’re over 65 and not enrolled, they should enroll as soon as possible. Penalties may apply, but enrolling prevents future increases.

If they get Social Security Disability, they are enrolled automatically after 24 months.

Answer: Medicare can feel confusing, but it helps to take it one step at a time. Start by learning what Original Medicare covers, then look at your doctors, prescriptions, and budget to find a plan that fits your needs. Don’t let TV ads or mailers overwhelm you — many of them just repeat the same information. Talking with a licensed agent can make things much easier, and reviewing your plan each year helps keep your coverage and costs in the right place.

Answer: Many seniors misunderstand Medicare’s coverage for long-term care. While Medicare covers short-term stays in skilled nursing facilities (like after surgery), it doesn’t cover long-term care in nursing homes or assisted living, especially if only custodial care (like help with bathing or dressing) is needed. It also doesn’t cover home care unless it's part of a skilled medical treatment plan, such as physical therapy. Medicare only covers up to 100 days of skilled nursing care, but after the first 20 days, there are daily out-of-pocket costs. Seniors often confuse Medicare with Medicaid, which is a separate program that helps with long-term care costs for those with low income. To cover gaps, many people explore long-term care insurance or Medicaid (if eligible) to help with these expenses.

Answer: Guaranteed Issue is like a safety net. If you lose coverage or make certain changes, you get a short window (usually 63 days) to buy a Medigap plan without health questions. Outside of these windows, you may have to go through medical underwriting and could be denied or charged more based on health.

Guaranteed Issue (GI) rights apply in several situations: your Medicare Advantage plan ends or you move out of its service area; your employer, union, COBRA, or retiree coverage ends; you joined Medicare Advantage or PACE at 65 and leave within the first 12 months; you dropped a Medigap policy to try Medicare Advantage and want to switch back within 12 months; or your insurance company goes bankrupt or misleads you.

Answer: If you’re a low-income senior struggling with prescription costs, start by applying for Extra Help (Low-Income Subsidy) through Social Security, which can drastically lower or even eliminate your Part D premiums, deductibles, and copays. You may also qualify for a Medicare Savings Program through your state, which helps pay Medicare costs and can automatically enroll you in Extra Help. In addition, look into State Pharmaceutical Assistance Programs (SPAPs) if your state offers them, and check with drug companies for Patient Assistance Programs, which provide free or discounted medications to those who qualify.

Answer: Medicare allows all the mail and TV ads because private insurance companies run Medicare Advantage and Supplement plans, and advertising is how they compete for your enrollment. The government sets rules to make sure ads aren’t outright false, but the rules still let insurers flood seniors with mailers, commercials, and phone calls. Since seniors are the main customers, companies spend billions on marketing, which can leave people feeling overwhelmed and confused even though the ads are technically allowed.

Answer: When you first sign up for Medicare, you get a special 6-month window to buy a Medicare Supplement (Medigap) plan. During that time, the insurance company has to accept you, no matter what health problems you have.

If you wait until after that window, the insurance company can say no, charge you more, or make you wait for coverage if you have health issues.

The only exceptions are special cases, like if you lose other health coverage or your Medicare Advantage plan ends in your area — then you get another chance where they can’t deny you.

Answer: A lot of people focus on premiums and routine coverage, but the real financial risk often comes from:

Hospitalizations (deductibles and daily copays)

Skilled nursing facility stays (covered only for a limited time)

Specialist visits and outpatient procedures (20% coinsurance under Part B, with no out-of-pocket maximum unless you have a Medicare Advantage plan or Medigap)

Medications (especially high-cost Part D drugs or infusion therapies)

Why it matters: If you don’t have Medigap or a Medicare Advantage plan, there’s no “cap” on what you might spend in a bad health year.

Answer: Good question — it depends on what kind of help you need.

Medicare’s rules on home health after surgery:

Covered (with doctor’s order): If your doctor says you’re “homebound” and you need skilled care (like nursing, physical therapy, or speech therapy), then Medicare Part A and/or B may cover short-term home health services. This can include:

Skilled nursing (wound care, injections, medication monitoring)

Physical/occupational/speech therapy

A home health aide, but only to help with personal care (like bathing, dressing) if you’re also getting skilled care.

Not covered: Medicare does not pay for full-time custodial care (help with meals, cleaning, errands, or ongoing personal care) if that’s the only service you need. For that type of help, you would generally have to pay out-of-pocket or look into long-term care insurance, Medicaid (if eligible), or local community resources.

✅ In short:

If you need skilled medical care at home, Medicare may also cover a home health aide for part-time help.

If you only need help with daily activities (no skilled medical care), you’d likely be on your own for the costs.

Answer: Automation makes Medicare processes faster by reducing paperwork and manual steps. It improves accuracy, cuts down on costly mistakes, and ensures rules are always followed. At the same time, it lowers costs and creates clear records for easy tracking and audits.

Answer: Good question. Having a Supplement or Advantage plan is beneficial in many ways. Let's look at what happens if you stick with Medicare A&B (you will need to get a Part D plan).

If you stick with Original Medicare alone (no Medigap):

No spending limit – you keep paying your share no matter how high the bills go.

Hospital stays get expensive – after a couple months, you could owe hundreds per day, then everything after that.

Big treatments will equal big bills – you pay 20% of things like surgery, cancer care, or dialysis, which can be tens of thousands.

No help overseas – Medicare doesn’t pay if you get sick outside the U.S.. Without a Supplement (also known as Medigap)or an Advantage plan, one major illness could drain your savings because there’s no cap on how much you might owe.

Answer: I'm general, Medicare will cover all regular cleanings, x-rays, etc. You and your agent should compare several carriers and note which have additional monies for additional services.

There are ancillary products, for a small fee, that will help cover expenses.